Teeth have an ideal positioning, as well as bone and muscle structures. However, several factors can influence the way these structures are related, and generate an unfavorable occlusion, either functionally or aesthetically.

Generally, patients seeking orthodontic treatment notice some irregularity in their smile, but what few people know is that this is called malocclusion and that there are several types of problems that can be in a misaligned smile.

In today’s content, you will be able to better understand the types of occlusion, their causes and treatments. Keep reading!

What is occlusion in dentistry?

Dental occlusion is the proper functional relationship among the teeth, jaws, temporomandibular joint, tongue, muscles and all other components of this system. Its proper balance is essential for chewing, swallowing, phonetics, breathing and aesthetics.

When there are changes in dental occlusion, such as a very projected jaw, missing teeth, dental inclinations, etc., the occlusion is not in harmony and, to this, we name dental malocclusion.

What are the types of malocclusion?

There are different types of dental malocclusions and they can occur concomitantly or as a one-off problem.

Some malocclusions arise as a result of bone discrepancies, i.e, poor positioning of the mandible and/or maxilla in relation to the bone base of the skull. Other malocclusions do not have a bone aspect, but a dental one.

Below you can check the most frequent types of malocclusions in the general population:

Open bite

An open bite can occur between the anterior or posterior teeth. It is characterized by the absence of touching the upper and lower teeth, creating a gap between them.

This type of malocclusion may have consequences for chewing, swallowing and phonetics, as poor dental positioning also affects the way other structures, such as the tongue, will position themselves.

Crossbite

Just as a lid has a suitable way of positioning itself on the pan, the dental arches need to relate in a specific way. The correct way for the upper and lower teeth to relate is for the upper arch to occlude so that the vestibular surfaces of the teeth are external to the vestibular surfaces of the lower arch.

When it occurs in reverse, the bite is crossed. And this can occur both in the anterior region and in the posterior region.

Deep overbite

When we touch the teeth, it is common for the upper teeth to cover a part of the lower teeth. However, when it occurs excessively, there is a problem called deep overbite or severe overbite. This malocclusion has an opposite aspect to the previous open bite.

Crowding

Dental crowding is the name given to the famous “crooked teeth”, and it is generally caused by the lack of space for the permanent tooth to be positioned properly. When it occurs, teeth tend to be allocated to positions where they fit and this generates smile misalignment. More than that, dental crowding can make proper oral hygiene difficult and increase the risk of gingival inflammation and the development of caries.

Class II malocclusion

All the malocclusions mentioned above can occur even if the bone relationship of the arches is adequate.

Class II malocclusion, in turn, deals precisely with bone disharmony, in which the mandible is retruded in relation to the skull base or the protruded mandible. In more complex cases, there may be changes in both the mandible and the maxilla. These cases can be diagnosed during childhood and treatment needs to be established at the right time, usually just before the growth spurt, to avoid further discrepancies and sometimes to avoid the need for orthognathic surgery in the future.

Class III malocclusion 

In Class III malocclusion, the opposite occurs, i.e, the mandible is protruded in relation to its bone base or the maxilla is retruded. There may also be somatization of discrepancies in the two structures. This type of change can be hereditary and requires a long treatment, which must be started as soon as possible and maintained until the end of the growth phase to avoid further problems and the need for surgery. However, sometimes, even with early treatment, patient may need orthognathic surgery in adulthood.

What are the main causes of malocclusion?

Malocclusions can be caused by different factors. Check out the main causes below:

Musculature action

Hyper or hypotonia of the muscles of the face can affect tooth positioning, while poor dental positioning can also aggravate muscular conditions. 

Early loss

The early loss of a deciduous (milk tooth) tooth can cause loss of space in the arch, delay in the eruption of the permanent tooth, or even the non-eruption and need for surgical intervention. More than that, the loss of permanent teeth may cause damage to the dental arch and the entire dentition, such as mesialization of adjacent teeth, extrusion of antagonist teeth and bone resorption.

Habits such as baby bottles, pacifier and suction

These habits affect the entire craniofacial development, mainly causing maxillary atresia and anterior open bite. The earlier these habits are intercepted, the less damage they generate and the possibility of spontaneous correction of minor problems.

Lack of space in the dental arch

Sometimes, even without early loss, there may be a lack of space for the proper eruption of permanent teeth, as these teeth are larger than milk teeth.

Hypertrophy of tonsils and adenoids

These problems interfere with breathing, causing the patient to breathe through the mouth. Mouth breathers tend to develop dental and, frequently, skeletal and muscular changes. Maxillary atresia and crossbite are the most frequent malocclusions in mouth breathers.

Tongue interposition

The tongue interposition between the anterior teeth during swallowing is a problem that may lead to changes in dental positioning, and the main consequence is the anterior open bite.

Types of treatment to improve occlusion

Currently, occlusion-related problems can be treated in different ways and by different specialties. It is important to emphasize that the planning of each case is individual and that not all possibilities can be applied in all cases. Check out alternative treatments below that can improve occlusion:

Orthodontics

When it is a dental positioning correction, orthodontics is certainly the specialty that can restore the patient’s occlusion, whether through removable braces, extraoral braces, fixed braces or even aligners.

Orthodontics has a range of possibilities for solving the different occlusion problems that the patient may have and the advances in this specialty provide high chances of success when there is assertiveness in the chosen treatment technique.

Prosthetic rehabilitation

There are occlusal problems occurring due to the absence of one or more permanent teeth. In these cases, prosthetic rehabilitation is essential to restore occlusion and function, either through fixed or removable prostheses or dental implants.

When tooth loss has occurred for a long time, there may be extrusion of antagonist teeth in addition to mesialization of adjacent teeth. The association with orthodontics optimizes cases like that, bringing many benefits to the rehabilitation treatment.

Dental veneers

Dental veneers can be used when the patient does not have very expressive occlusal problems and just wants a better anterior teeth appearance to increase the smile aesthetics.

It is important to emphasize that dental veneers do not correct occlusal problems, but contribute to the aesthetics of small misalignments when the patient does not wish to undergo orthodontic treatment.

Check out more Aditek content prepared especially for dentists!

The orthodontist is the specialist responsible for treating malocclusions, having the knowledge to act not only on the tooth, but on bone structures of the face.

Do not forget that balanced dental occlusion goes far beyond the beauty of the smile: it also contributes to chewing, swallowing and phonetics. Consequently, for an individual’s breathing, nutrition, speech, self-esteem and quality of life!

Read more contents from Aditek’s blog, created by specialists in the field, and learn about the brand’s high-tech orthodontic products.